Impaired quality of life, but not cognition, is linked to a history of chronic hypercortisolism in patients with Cushing's disease in remission

ContextImpaired cognition and altered quality of life (QoL) may persist despite long-term remission of Cushing's disease (CD). Persistent comorbidities and treatment modalities may account for cognitive impairments. Therefore, the role of hypercortisolism per se on cognitive sequelae remains de...

Descripción completa

Detalles Bibliográficos
Autores: Pupier, E, Santos, A, Etchamendy, N, Lavielle, A, Ferriere, A, Marighetto, A, Resmini, E, Cota, D, Webb, SM, Tabarin, A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p12255
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=12255
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85136479418&doi=10.3389%2ffendo.2022.934347&partnerID=40&md5=91ae6e8584d5c71af7d207a7ba35c7c0
Access Level:acceso abierto
Palabra clave:Cushing's disease
hypercortisolism
cognition
memory
quality of life
id ES_dc4e4349d0db134ddc5dffc2d36d437b
oai_identifier_str oai:iibsantpau.fundanetsuite.com:p12255
network_acronym_str ES
network_name_str España
repository_id_str
spelling Impaired quality of life, but not cognition, is linked to a history of chronic hypercortisolism in patients with Cushing's disease in remissionPupier, ESantos, AEtchamendy, NLavielle, AFerriere, AMarighetto, AResmini, ECota, DWebb, SMTabarin, ACushing's diseasehypercortisolismcognitionmemoryquality of lifeContextImpaired cognition and altered quality of life (QoL) may persist despite long-term remission of Cushing's disease (CD). Persistent comorbidities and treatment modalities may account for cognitive impairments. Therefore, the role of hypercortisolism per se on cognitive sequelae remains debatable. ObjectiveTo investigate whether memory and QoL are impaired after long-term remission of CD in patients with no confounding comorbidity. Design and SettingCross-sectional case-control study in two tertiary referral centers Patients25 patients (44.5 +/- 2.4 years) in remission from CD for 102.7 +/- 19.3 Mo and 25 well-matched controls, without comorbidity or treatment liable to impair cognition. Main Outcome Measure(s)Hippocampus- and prefrontal cortex-dependent memory, including memory flexibility and working memory, were investigated using multiple tests including sensitive locally-developed computerized tasks. Depression and anxiety were evaluated with the MADRS and HADS questionnaires. QoL was evaluated with the SF-36 and CushingQoL questionnaires. The intensity of CD was assessed using mean urinary free cortisol and a score for clinical symptoms. ResultsCD patients displayed similar performance to controls in all cognitive tests. In contrast, despite the absence of depression and a minimal residual clinical Cushing score, patients had worse QoL. Most of the SF36 subscales and the CushingQoL score were negatively associated only with the duration of exposure to hypercortisolism (p <= 0.01 to 0.001). ConclusionsPersistent comorbidities can be a primary cause of long-lasting cognitive impairment and should be actively treated. Persistently altered QoL may reflect irreversible effects of hypercortisolism, highlighting the need to reduce its duration.FRONTIERS MEDIA SA2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=12255https://www.scopus.com/inward/record.uri?eid=2-s2.0-85136479418&doi=10.3389%2ffendo.2022.934347&partnerID=40&md5=91ae6e8584d5c71af7d207a7ba35c7c0Frontiers in EndocrinologyISSN: 16642392reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p122552026-06-14T12:41:47Z
dc.title.none.fl_str_mv Impaired quality of life, but not cognition, is linked to a history of chronic hypercortisolism in patients with Cushing's disease in remission
title Impaired quality of life, but not cognition, is linked to a history of chronic hypercortisolism in patients with Cushing's disease in remission
spellingShingle Impaired quality of life, but not cognition, is linked to a history of chronic hypercortisolism in patients with Cushing's disease in remission
Pupier, E
Cushing's disease
hypercortisolism
cognition
memory
quality of life
title_short Impaired quality of life, but not cognition, is linked to a history of chronic hypercortisolism in patients with Cushing's disease in remission
title_full Impaired quality of life, but not cognition, is linked to a history of chronic hypercortisolism in patients with Cushing's disease in remission
title_fullStr Impaired quality of life, but not cognition, is linked to a history of chronic hypercortisolism in patients with Cushing's disease in remission
title_full_unstemmed Impaired quality of life, but not cognition, is linked to a history of chronic hypercortisolism in patients with Cushing's disease in remission
title_sort Impaired quality of life, but not cognition, is linked to a history of chronic hypercortisolism in patients with Cushing's disease in remission
dc.creator.none.fl_str_mv Pupier, E
Santos, A
Etchamendy, N
Lavielle, A
Ferriere, A
Marighetto, A
Resmini, E
Cota, D
Webb, SM
Tabarin, A
author Pupier, E
author_facet Pupier, E
Santos, A
Etchamendy, N
Lavielle, A
Ferriere, A
Marighetto, A
Resmini, E
Cota, D
Webb, SM
Tabarin, A
author_role author
author2 Santos, A
Etchamendy, N
Lavielle, A
Ferriere, A
Marighetto, A
Resmini, E
Cota, D
Webb, SM
Tabarin, A
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Cushing's disease
hypercortisolism
cognition
memory
quality of life
topic Cushing's disease
hypercortisolism
cognition
memory
quality of life
description ContextImpaired cognition and altered quality of life (QoL) may persist despite long-term remission of Cushing's disease (CD). Persistent comorbidities and treatment modalities may account for cognitive impairments. Therefore, the role of hypercortisolism per se on cognitive sequelae remains debatable. ObjectiveTo investigate whether memory and QoL are impaired after long-term remission of CD in patients with no confounding comorbidity. Design and SettingCross-sectional case-control study in two tertiary referral centers Patients25 patients (44.5 +/- 2.4 years) in remission from CD for 102.7 +/- 19.3 Mo and 25 well-matched controls, without comorbidity or treatment liable to impair cognition. Main Outcome Measure(s)Hippocampus- and prefrontal cortex-dependent memory, including memory flexibility and working memory, were investigated using multiple tests including sensitive locally-developed computerized tasks. Depression and anxiety were evaluated with the MADRS and HADS questionnaires. QoL was evaluated with the SF-36 and CushingQoL questionnaires. The intensity of CD was assessed using mean urinary free cortisol and a score for clinical symptoms. ResultsCD patients displayed similar performance to controls in all cognitive tests. In contrast, despite the absence of depression and a minimal residual clinical Cushing score, patients had worse QoL. Most of the SF36 subscales and the CushingQoL score were negatively associated only with the duration of exposure to hypercortisolism (p <= 0.01 to 0.001). ConclusionsPersistent comorbidities can be a primary cause of long-lasting cognitive impairment and should be actively treated. Persistently altered QoL may reflect irreversible effects of hypercortisolism, highlighting the need to reduce its duration.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=12255
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85136479418&doi=10.3389%2ffendo.2022.934347&partnerID=40&md5=91ae6e8584d5c71af7d207a7ba35c7c0
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=12255
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85136479418&doi=10.3389%2ffendo.2022.934347&partnerID=40&md5=91ae6e8584d5c71af7d207a7ba35c7c0
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv FRONTIERS MEDIA SA
publisher.none.fl_str_mv FRONTIERS MEDIA SA
dc.source.none.fl_str_mv Frontiers in Endocrinology
ISSN: 16642392
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869421756326871040
score 15,811543

Similares en LA Referencia